Variability in adequacy of ventilation during transport of cardiac surgery patients: a cohort study

Rajasekaram, R., Reade, M. C., Shortal, B., Hart, G. K., Shaw, M. and Bellomo, R. (2011) Variability in adequacy of ventilation during transport of cardiac surgery patients: a cohort study. Anaesthesia and Intensive Care, 39 3: 465-471.

Author Rajasekaram, R.
Reade, M. C.
Shortal, B.
Hart, G. K.
Shaw, M.
Bellomo, R.
Title Variability in adequacy of ventilation during transport of cardiac surgery patients: a cohort study
Journal name Anaesthesia and Intensive Care   Check publisher's open access policy
ISSN 0310-057X
1448-0271
Publication date 2011-05-01
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 39
Issue 3
Start page 465
End page 471
Total pages 7
Place of publication North Sydney, NSW, Australia
Publisher Australian Society of Anaesthetists
Language eng
Formatted abstract
Inadequate ventilation of intubated patients during transport from the operating theatre to the intensive care unit with attendant hypercarbia may adversely affect haemodynamics. In a retrospective observational study, we assessed the incidence of inadequate ventilation during transport from the operating theatre to the intensive care unit in 99 consecutive cardiac surgery patients admitted to our university tertiary hospital.
Demographic, clinical, arterial blood gas and haemodynamic measurements were made on arrival in the intensive care unit after cardiac surgery. The relationships between arterial carbon dioxide tension (PaCO2), mean pulmonary artery pressure (MPAP) and other relevant haemodynamic variables were explored. Overall, hypocarbia (PaCO2 <35 mmHg) occurred in 18.2% of patients, while 28.3% of patients had hypercarbia (PaCO2 >45 mmHg). Pulmonary hypertension was common, with nearly half of the cohort having MPAP ≥25 mmHg and 17.2% ≥30 mmHg. However, there was no association between PaCO2 and MPAP (R2=0.0076, P=0.39). Contrary to expectation, neither hypercarbia nor high MPAP were associated with measured adverse outcomes, although this may have been because we studied an insufficient number of patients with extreme values. Associations of higher MPAP, which would be expected to compromise cardiovascular status, included acidaemia, hypoxia and the requirement for noradrenaline. These factors define a group of high-risk patients who should receive particular attention and who should be the focus of future studies.
Keyword Ventilation
Cardiac surgery
Hypercarbia
Pulmonary artery pressure
Cardiopulmonary bypass
Hypercarbia
Hypercapnia
Paco2
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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